Provider Demographics
NPI:1326242926
Name:BIDYASAR, SAVITA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAVITA
Middle Name:
Last Name:BIDYASAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 0070
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31603-0070
Mailing Address - Country:US
Mailing Address - Phone:229-259-4611
Mailing Address - Fax:229-259-4664
Practice Address - Street 1:2501 N. PATTERSON STREET
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1735
Practice Address - Country:US
Practice Address - Phone:229-259-4611
Practice Address - Fax:229-259-4664
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA070049207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2776325012OtherMYUTMB 2776325012-COMMERCIAL NUMBER